Tubulointerstitial nephritis is a common kidney disease and canal disease that leads to impaired organ function. The disease is characterized by extensive changes in the structure of interstitial renal tissues. There are two types of the course of the disease - acute and chronic. In the instructions for many medicines that enter the human body, it is mentioned that the drugs are excreted through the kidneys. Thoughtless and uncontrolled use of medications leads to the occurrence of the disease due to allergies to certain drugs or herbal therapy. The disease also occurs as a result of an infection.
To detect tubulointerstitial nephritis, modern body research methods are used, namely: ultrasound, urine and blood analysis, history taking, kidney biopsy. The conclusion regarding the reversibility of the disease is made on the basis of the severity of the damage and the timing of seeking medical help.
Causes causing disease
Sometimes taking antibiotics or other anti-inflammatory drugs is stretched out for a long time. And kidney damage occurs after severe poisoning with chemicals, heavy metals. Ethanol vapors are especially destructive. Tubulointerstitial nephritis can occur for many reasons:
- after a viral infection - in 46% of cases;
- toxic manifestations of an allergic nature provoke the disease in 28.3%;
- metabolic disorders in the body contribute to the occurrence of the disease in 13.9%;
- impaired circulatory function of the ureters – 8.8%;
- genetic and immune causes - in 0.9% of diseases;
- multiple causes observed in 2.5% of cases.
Chronic forms of the disease are caused by serious violations of the integrity of cytomembranes, dysplasia of kidney tissues, metabolic changes, congenital and acquired anomalies of the ureters.
Diagnosis
A number of physical and laboratory studies are being carried out. Only then is an accurate diagnosis made. Tubulointerstitial nephritis is suspected in a patient presenting with prominent symptoms that are self-diagnosed by physical manifestations.
A chronic disease is a consequence of infiltration and atrophy of channels in the human body for a long time. The function of the organ is inhibited gradually - over several years. The patient goes to the doctor when they appearunpleasant symptoms such as kidney pain, rash and others. They give him significant discomfort. The disease affects two kidneys at once or damages only one.
In a laboratory study of urine, a urinary sediment with a high content of erythrocytes and leukocytes is clearly visible. In this case, there is a complete absence of erythrocytes of a dysmorphic type and only a slight manifestation of hematuria. The presence of eosinophils in the urine does not characterize the presence of the disease, since only in 50% of cases they are the result of an illness. If they are not present at all, then this indicates that the disease is absent. Proteinuria is detected by minimal indicators, but if the body has already developed glomerular pathology caused by the use of antibiotics, then this indicator reaches the nephrotic level.
In the blood test, acute tubulointerstitial nephritis manifests itself as hypercalcemia. Dysfunction of the channels leads to metabolic acidosis. Ultrasound examination greatly increases the echogenicity index due to the development of edema of the organ and the process of infiltration. Ultrasound shows an increase in the size of the kidneys, an increase in the rate of radioactive gallium and leukocytes noted in the process by radionuclides. A positive scan indicates tubulointerstitial nephritis. A negative test must be confirmed by other methods.
Symptoms of the disease
In the first stages of the disease, symptoms do not appear. Some patients are unaware of the developingpathology. Later periods of the course of the disease make themselves felt by expressive signs:
- rashes appear partially or on the entire surface of the body, wearing an itchy character;
- the temperature rises within a small range, severe cases are marked by a febrile state;
- kidney pain is felt constantly or with frequent passing attacks;
- fatigue increases, the patient feels rolling drowsiness;
- pressure surges are observed for no apparent reason;
- polyuria occurs.
Tubulointerstitial nephritis is marked by many diverse manifestations. Symptoms are observed in the form of fever and rashes, but these changes in the body alone are not enough to make a diagnosis. The rash occurs one month after exposure to the toxin or within 3-6 days. It depends on the state of the body and its reaction to the allergen. There is weight loss, pain in the abdomen and in the back above the buttocks.
A disease that has passed into the chronic stage is distinguished at some time by mild symptoms that worsen over time. Some people develop nocturia and polyuria. An increase in blood pressure and swelling of the extremities are not observed until renal failure occurs. The symptoms described in the list are typical for the acute stage of the disease.
Chronic nephritis
The disease becomes chronic after an acute course. But such cases are rare. Most often, chronic nephritis develops afterpast infection, persistent metabolic disorders in the body, permanent drug intoxication. Chronic tubulointerstitial nephritis on ultrasound shows normal or destroyed glomeruli. Tubules are completely absent or deformed. There are different gaps of the canals - from narrowed to wide with homogeneous shells.
Kidney tissue is prone to fibrosis and inflammation. If numerous fibrosis is absent, then the parenchyma looks almost he althy. Atrophied kidneys are small and show signs of asymmetry. The symptoms of chronic nephritis are similar to those of the acute stage, but have a less pronounced manifestation. Leukocytosis and elevated red blood cells are rare. The chronic course of the disease is very dangerous, so you need to carefully listen to the symptoms in the early stages of the disease. Late treatment leads to kidney failure, which is fraught with big trouble.
Acute disease
Often occurs as a result of improper self-treatment without consulting a doctor. Inability of the kidneys to perform their functions, the appearance of acute inflammatory processes appear after a long time of use in the treatment of beta-lactamide antibiotics.
Acute nephropathy is characterized by the presence of peripheral edema and inflammatory infiltration. They spread to the kidney tissue. It sometimes takes several weeks before the onset of severe symptoms. Then acute renal failure develops, which is provokeduntimely start of treatment and continued exposure to an irritating factor.
Baby jade
The opportunity to avoid the development of the disease in childhood is the timely visit to the doctor in case of any ailments, starting with colds. You can’t self-medicate, only a practicing pediatrician will select medicines that do not harm the child’s unformed immune system.
Tubulointerstitial nephritis in children is treated under the supervision of a specialist. In parallel, a therapeutic diet is prescribed, without which positive results are more difficult to achieve. In the case of advanced nephritis, the diseased kidney cannot be cured, then they resort to organ transplantation. Childhood is characterized by an undulating course of the disease with a long latent period.
Disease prognosis
Tubulointerstitial nephritis occurs when kidney function is compromised by drugs. Treatment in mild cases is not required. Stop taking the medicine, and the kidneys begin normal work after 2-2.5 months. Sometimes scarring is a residual phenomenon. With a disease of a different etiology, the cause is eliminated, but the disease is reversible. In severe cases, kidney failure and fibrosis remain.
The prognosis of the chronic form of nephritis depends on the speed of detection and reduction of pathology before an irreversible form of fibrosis appears. If it is impossible to correct genetic, toxic and metabolic changes, the disease passes into thermal renalfailure.
Cure disease
At the first symptoms of an illness, you need to see a doctor. Only he will select the correct and competent treatment. Therapy for each patient is individual. But, for example, to speed up recovery in the acute stage of the disease, and sometimes chronic, glucocorticoids are used. It slows down the process of taking angiotensin blockers, inhibitors.
Kidney biopsy
The procedure refers to diagnostic measures to detect kidney disease. It is the removal of a piece of tissue for microscopic examination. A small amount of renal material is collected through a thin syringe needle. Such a study helps to effectively determine the chemical composition of the tissue and select the optimal treatment method.
Indications for a biopsy
Research by biopsy is prescribed in the following cases:
- The cause of a chronic or acute illness has not yet been fully determined.
- Jade is suspected.
- Renal failure progresses rapidly.
- There is a complex infectious etiology.
- Laboratory tests of urine revealed an admixture of blood and protein.
- Blood test shows high levels of uric acid, creatinine, urea.
- Cancer is suspected.
- Transplanted kidney functions with problems.
- There is a need to determine the extent of damage.
- To monitor the progress of treatment.
Varietiesbiopsy
The procedure is done through the skin. It is performed with an injection over the kidneys and is controlled by x-rays or ultrasound. To facilitate the location of the organ, a color-contrasting neutral substance is injected into the veins. An open biopsy procedure is characterized by taking a small amount of tissue directly during surgery. For example, when an oncological neoplasm is removed. The procedure is indicated for those who have bleeding or have only one kidney in working condition. This is done to reduce the risk of exposure to her.
Combined biopsy with ureteroscopy is performed in the presence of stones in the ureter or renal pelvis. Done in the operating room and is the introduction of a flexible tube for internal examination of the ureter. A transjugular type of biopsy is the insertion of a catheter into a selected renal vein. It is used in patients with obesity, chronic respiratory failure and poor blood clotting, when none of the above methods is performed due to a threat to life and does not reveal tubulointerstitial nephritis.
In conclusion, it should be said that the disease, which at first glance occurs without symptoms that do not disturb the patient, in fact, needs to be detected in time. Complicated and untreated nephritis weakens kidney function and leads to irreversible consequences.
